1. Presented By: DHCS and CDA Date: October 23, 2013 1

2. 2 Webinar Housekeeping

3. Presenters 3 Department of Health Care Services (DHCS) Jane Ogle, Deputy Director Health Care Delivery Systems John Shen, Chief Long-Term Care Division California Department of Aging (CDA) Ed Long, Deputy Director Long-Term Care and Aging Services Division Denise Peach, Chief Community Based Adult Services (CBAS) Branch

4. Agenda 4 Welcome and Overview Look Back – 2011 to Present and What Brings Us Here Today Stakeholder Process Overview – What, When, Who, How Key Issues and Considerations Questions and Answers Summary

5. Webinar Objectives 5 Provide parties interested in the CBAS Program: An overview of the upcoming CBAS Stakeholder Process An understanding of why DHCS and CDA are conducting the Stakeholder Process

6. Welcome and Background 6 Jane Ogle Ed Long John Shen

7. Recap: 2011 - Present 7 Darling v. Douglas Settlement California Bridge to Reform (BTR) 1115 Demonstration Waiver Timelines Key Provisions CBAS Special Terms and Conditions (STCs), Standards of Participation Incorporation of Darling v. Douglas Settlement Terms CBAS as a Medi-Cal Managed Care benefit

8. What Brings Us Here Today? 8 DeadlinesCBAS STCs in the BTR 1115 Waiver Set to Expire 08/31/14 Need to Renew CBAS Waiver STCs CBAS is a key component of Long Term Services and Supports (LTSS) under the Coordinated Care Initiative (CCI) CBAS is an important Home and Community-Based Service (HCBS) that provides alternatives to institutional care

9. Stakeholder Process Overview 9 What When Who How

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11. What the Stakeholder Process Is 11 A series of meetings/webinars and opportunities for interested parties to provide DHCS and CDA with: Input regarding the future direction of the CBAS Program Recommendations for amending the CBAS Special Terms and Conditions (STCs) in the BTR 1115 Waiver

12. When Meetings and Webinars Will Take Place 12 October 2013 CBAS Stakeholder Process Kick Off Webinar, 3-5pm December 2013 Stakeholder Workgroup Meeting, 2-5pm January 2014 Stakeholder Workgroup Meeting, 2-5pm February 2014 October 2013 March 2014April 2014 Stakeholder Workgroup Meeting, 2-5pm Stakeholder Workgroup Meeting, 2-5pm CBAS Stakeholder Process Summary Webinar, 3-5pm 23 4 39 610

13. Who Will Participate 13 Broad Stakeholders/Interested Parties Managed Care Plans Providers and Representatives Advocates and Consumers Legislative Staff State Departments Workgroup (15-20 Members)

14. How the Process Will Work 14 Workgroup Meetings Workgroup members attend and actively participate during meeting Meetings are open – interested parties can attend or phone in. Registration information will be provided with agenda and meeting materials prior to each meeting DHCS and CDA will provide progress updates after each webinar/meeting and invite written feedback. (Please note that public input may be provided anytime via mail, email or phone) Feedback will be summarized and shared via CBAS Stakeholder webpage

15. How the Process Will Work (cont.) 15 DHCS and CDA will provide updates to the Olmstead Advisory Committee at their quarterly meetings and to the legislature after each workgroup meeting Workgroup will make recommendations for Waiver amendments and future CBAS initiatives after final meeting

16. How the Process Will Work (cont.) 16 At the conclusion of the Workgroup meetings DHCS and CDA will conduct a webinar at the end of the Workgroup meetings (April 10 th ) to summarize Stakeholder input and recommendations DHCS and CDA will work with CMS on CBAS STC amendments and Waiver renewal process

17. Where To Get Updates and Give Input 17 Written Feedback California Department of Aging CBAS Branch 1300 National Drive, Suite 200 Sacramento, CA 95834-1992 cbascda@aging.ca.gov CBAS Stakeholders on the Webwww.aging.ca.gov Phone(916) 419-7545

18. Key Issues and Considerations 18 How Much Change … Is needed or wanted? Can be accomplished on the Waiver renewal timeline (i.e., Waiver submission to CMS by May 2014) What Should Be Addressed … Short-term Medium-term Long-term … and how

19. Key Issues and Considerations (cont.) 19 ADHC CBAS Transition Which Waiver STCs applied to ADHC transition and may no longer be relevant? Transition face-to-face (F2F) provisions Enhanced Case Management ADHC participant protections and noticing CBAS Fully Transitioned to Managed Care How should CBAS work in the context of how managed care works? How should CBAS work with other LTSS under CCI? Which current CBAS requirements – e.g., eligibility determination processes, contracting, staffing, etc., make sense in the managed care environment?

20. Q & A 20

21. Wrap Up 21 What we’ve covered today Where we’re heading tomorrow

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